Piscotty Ronald J, Kalisch Beatrice, Gracey-Thomas Angel
Theta Psi, Assistant Professor, Wayne State University College of Nursing, Detroit, MI.
Rho, Titus Professor, University of Michigan School of Nursing, Ann Arbor, MI.
J Nurs Scholarsh. 2015 Jul;47(4):287-93. doi: 10.1111/jnu.12138. Epub 2015 May 6.
To report additional mediation findings from a descriptive cross sectional study to examine if nurses' perceptions of the impact of healthcare information technology on their practice mediates the relationship between electronic nursing care reminder use and missed nursing care.
The study used a descriptive design. The sample (N = 165) was composed of registered nurses working on acute care hospital units. The sample was obtained from a large teaching hospital in Southeast Michigan in the fall of 2012. All eligible nursing units (n = 19) were included.
The MISSCARE Survey, Nursing Care Reminders Usage Survey, and the Impact of Healthcare Information Technology Scale were used to collect data to test for mediation. Mediation was tested using the method described by Baron and Kenny. Multiple regression equations were used to analyze the data to determine if mediation occurred between the variables.
Missed nursing care, the outcome variable, was regressed on the predictor variable, reminder usage, and the mediator variable impact of technology on nursing practice. The impact of healthcare information technology (IHIT) on nursing practice negatively affected missed nursing care (t = -4.12, p < .001), explaining 9.8% of variance in missed nursing care. With IHIT present, the predictor (reminder usage) was no longer significant (t = -.70, p = .48). Thus, the reduced direct association between reminder usage and missed nursing care when IHIT was in the model supported the hypothesis that IHIT was at least one of the mediators in the relationship between reminder usage and missed nursing care.
The perceptions of the impact of healthcare information technology mediates the relationship between nursing care reminder use and missed nursing care. The findings are beneficial to the advancement of healthcare technology in that designers of healthcare information technology systems need to keep in mind that perceptions regarding impacts of the technology will influence usage.
Many times, information technology systems are not designed to match the workflow of nurses. Systems built with redundant or impertinent reminders may be ignored. System designers must study which reminders nurses find most useful and which reminders result in the best quality outcomes.
报告一项描述性横断面研究的额外中介分析结果，以检验护士对医疗信息技术对其执业影响的认知是否介导了电子护理提醒使用与护理缺失之间的关系。
本研究采用描述性设计。样本（N = 165）由在急症护理医院科室工作的注册护士组成。样本于2012年秋季从密歇根州东南部的一家大型教学医院获取。所有符合条件的护理科室（n = 19）均被纳入。
使用MISSCARE调查问卷、护理提醒使用情况调查问卷以及医疗信息技术影响量表来收集数据以检验中介效应。采用Baron和Kenny描述的方法检验中介效应。使用多元回归方程分析数据以确定变量之间是否存在中介效应。
将护理缺失这一结果变量对预测变量提醒使用情况以及中介变量技术对护理执业的影响进行回归分析。医疗信息技术（IHIT）对护理执业的影响对护理缺失产生了负面影响（t = -4.12，p < .001），解释了护理缺失中9.8%的方差变异。当存在IHIT时，预测变量（提醒使用情况）不再显著（t = -.70，p = .48）。因此，当IHIT纳入模型时，提醒使用情况与护理缺失之间直接关联的减弱支持了以下假设：IHIT至少是提醒使用情况与护理缺失之间关系的中介因素之一。
对医疗信息技术影响的认知介导了护理提醒使用与护理缺失之间的关系。这些发现对医疗技术的进步有益，因为医疗信息技术系统的设计者需要牢记，对技术影响的认知将影响其使用。
很多时候，信息技术系统的设计与护士的工作流程不匹配。带有冗余或无关提醒的系统可能会被忽视。系统设计者必须研究护士认为哪些提醒最有用以及哪些提醒能带来最佳质量结果。
